India short of 6 lakh doctors, 2 million nurses: U.S. study

For Prelims and Mains: Key facts on India’s healthcare industry and concerns raised by the report, what needs to be done?

Context: US -based Center for Disease Dynamics, Economics & Policy (CDDEP) has released a report on the state of health services.

Key findings:

India specific:

India has a shortage of an estimated 600,000 doctors and 2 million nurses. There is one government doctor for every 10,189 people (the World Health Organisation (WHO) recommends a ratio of 1:1,000).

Lack of access to antibiotics kills more people currently than does antibiotic resistance.

65% of health expenditure is out-of-pocket, and such expenditures push some 57 million people into poverty each year.

Global scenario:

The majority of the world’s annual 5.7 million antibiotic-treatable deaths occur in low- and middle-income countries, where the mortality burden from treatable bacterial infections far exceeds the estimated annual 700,000 deaths from antibiotic-resistant infections.

Even after the discovery of new antibiotic, regulatory hurdles and substandard health facilities delay or altogether prevent widespread market entry and drug availability.

Worldwide, the irrational use of antibiotics and poor antimicrobial stewardship lead to treatment failure and propagate the spread of drug resistance which, in turn, further narrows the available array of effective antibiotics.

Concerns:

The lack of staff who are properly trained in administering antibiotics is preventing patients from accessing live-saving drugs.

High out-of-pocket medical costs to the patient are compounded by limited government spending for health services.

Some of the key roadblocks for India’s healthcare industry:

Population: India has the world’s second-largest population, rising from 760 million in 1985 to an estimated 1.3 billion in 2015.

Infrastructure: The existing healthcare infrastructure is just not enough to meet the needs of the population. The central and state governments do offer universal healthcare services and free treatment and essential drugs at government hospitals. However, the hospitals are, understaffed and under-financed, forcing patients to visit private medical practitioners and hospitals.

Insurance: India has one of the lowest per capita healthcare expenditures in the world. Government contribution to insurance stands at roughly 32 percent, as opposed to 83.5 percent in the UK. The high out-of-pocket expenses in India stem from the fact that 76 percent of Indians do not have health insurance.

Rural-urban disparity: The rural healthcare infrastructure is three-tiered and includes a sub-center, primary health centre (PHC) and CHC. PHCs are short of more than 3,000 doctors, with the shortage up by 200 per cent over the last 10 years to 27,421.

Other issues include:

Weak governance and accountability.

Irrational use and spiralling cost of drugs.

Fragmented health information systems.

Low public spending on health.

Large unregulated private sector.

Unequally distributed skilled human resources.

A weak primary healthcare sector.

Sources: the hindu.

Mains Question: Critically examine whether making healthcare affordable through capping of prices would solve the problem of Out of Pocket Expenditure in health in India?